Abstract

Background: Infidelity is an interpersonal traumatic incident that can have cognitive, emotional and behavioral consequences for the victim. This study aimed to explain the effectiveness of Robert Enright Forgiveness Inventory (EFI) on the marital quality of women affected by infidelity in Ahvaz. Methods: In this research, a single-case experimental design was used. The population included all women affected by infidelity referring to Ahvaz counseling centers in 2016. The study sample which included 4 women referring to Ahvaz Avaye Daroon Center was selected using available sampling method. The participants responded to the Marital Quality Questionnaire during the treatment and follow-up phases. The data were analyzed using visual analysis, clinical significance (Reliable Change Index and Normative Comparison), and the recovery percentage formula. Findings: The results indicated that the marital quality increased in women in the treatment (40.37) and (44.88) follow-up phases. According to the normative comparisons, t was bigger than the table with the degree of freedom of 32; therefore, it can be argued that there was no clinical difference between the normal and abused groups in terms of marital quality. Conclusion: Robert Enright Forgiveness Inventory (EFI) aims to change beliefs, advocate positive thinking, increase the sense of tranquility, reduce the sense of revenge and teach communication skills. These measures can help increase the marital quality of women affected by infidelity.

Keywords

Infidelity, Robert Enright forgiveness therapy, Marital quality.

Introduction

Marriage is the most important contract in every person's life.
People get married for various reasons. In addition to sexual
needs, which are prerequisite factors such as love, emotional
and financial security, relaxation, and escape from loneliness
contribute to marriage [1]. Marriage helps constitute the
family. Accordingly, the family essentially provides help,
relief, and relaxation. The family is supposed to reduce the
pressure on members and help them grow and flourish. If the
family provides a healthy and constructive environment for the
members and satisfies their physical and mental needs, they
may less likely to need the medical institutions [2,3]. Infidelity
is one of the factors that endangers the health of the family. It
is one of the main causes of divorce and disintegration of the
family [4]. Infidelity is a shocking issue for couples and
families, and a common phenomenon for family therapists
[5,6]. Infidelity is a violation of a couple’s assumed or stated
contract regarding emotional or sexual exclusivity [7]. The
institution of marriage is integral to the existence of the
family. We believe that marriage is a social as well as personal
good, contributing to the health and happiness of both spouses
and their children. Scientific evidence from a variety of fields
as well as human experience have shown that any deviation
from this norm is harmful, even if sometimes unpreventable as
in the case of death. It is still more harmful when this variation
challenges the institution of marriage itself, as in the cases of
same-sex unions and casual divorce.

According to Gordon [8], infidelity has adverse and unpleasant
side effects and causes stress, shock, anger, depression,
sadness, loss of self-esteem, and so on. Infidelity can be
manifested on a large scale and cause irreparable damages for
the couples affected by it. Regarding the cognitive dimensions,
infidelity can lead to rumination, depression and negative
thoughts. Meanwhile, it may also lead to anger, annoyance,
low self-esteem and low self-confidence. It may also have
behavioral consequences such as aggression, retaliation or
physical aggression [9]. The adverse complications mentioned
above can affect the quality of life of couples. The World
Health Organization (WHO) defines the quality of life as the
personal perceptions of individuals about their place in life,
given the cultural values that individuals live with and follow
their goals, expectations and standards of living [10]. One of
the essential components of quality of life is the concept of
marital quality. Marital quality can be considered as a
psychological state, which is not created spontaneously. The
couples need to work together in order to enhance this quality.
Particularly in the early years, marital quality is extremely
unstable, being exposed to the highest risk. Accordingly, the divorce rate suggests that the quality of life of couples is not
easily predictable [10]. Research indicates that poor marital
quality is one of the predictors of infidelity [11]. In some
studies, marital commitment has been considered as one of the
indicators of marital quality [12].

Accordingly, marital quality can be regarded as the successful
performance of a marriage, which is the result of various
factors such as couples' reconciliation and commitment to one
another. It is also one of the most important predictors of a
stable marriage [13]. The findings suggest that couples affected
by infidelity can be helped in several ways [5,14]. Experts
argue that infidelity is different from other problems couples
face and requires special attention in terms of therapeutic
strategies [9]. Given the fact many studies that have been
conducted on infidelity [15], therapists state that they have no
model for addressing this problem. Given the complex nature
of the infidelity and its disastrous effects on couples, effective
interventions are needed to help couples. Various theoretical
models have been presented to explain and treat couples
suffering from infidelity problems, including Emotional
Focused Therapy (EFT), Forgiveness Therapy, Cognitive-
Behavioural Therapy, Traumatic Model and Ritual Model.
Robert Enright Forgiveness Inventory (EFI) is one of the
approaches used to control and treat infidelity reactions [14].
The Enright Forgiveness Inventory (EFI) is an objective
measure of the degree to which one person forgives another
who has hurt him or her deeply and unfairly. The EFI has sixty
items and three subscales of twenty items each that assess the
domains of affect, behavior and cognition toward the offending
other. The manual provides administration and scoring
instructions, the establishment of validity and internal
consistency, national and international norm tables, and a
bibliography of forgiveness research articles. The manual also
presents evidence of the association between high scores on the
EFI and low scores on measures of anxiety (STAI) and
depression (BDI).

There has been growing research on the forgiveness in the past
decade due to the shift in focus from treatment to personal
growth. This positive shift has attracted the attention of
scientists and the general public, since it focuses on positive
emotions such as hope, appreciation, wonder and joy, using a
distinctive language [14]. Forgiveness can be a barrier to the
negative effects such as stress and negative emotions [16].
Forgiveness expands the cognitive and behavioural framework
of individuals and creates new adaptive techniques for them.
Forgiveness can also be considered as an interpersonal process
in relationships. As initial focus of psychological research on
the issue of forgiveness, researchers investigated the victims
who chose to forgive the abusers of the offense [14].

Forgiveness enables a person to maintain and retrieve
relationships in times of conflict. Forgiveness is getting rid of
negative emotions, cognitions and behaviors such as hostility,
revenge, and verbal aggression in response to injustices [9].
Enright Forgiveness Inventory (EFI) has four phases:

• Disclosure

• Decision-making

• Action

• Deepening

In the disclosure phase, issues such as psychological defences,
exposing anger, accepting anger, knowledge of the cognitive
review, guilt, insights into the people affected and insights
about the future are examined. In the decision-making phase,
issues such as insight into the old strategies, considering the
forgiveness as an option and forgiving the abuser are
investigated. The third phase deals with re-framing, empathy
and acceptance of pain and suffering. In the deepening phase,
issues such as finding the meaning of life, the need to forgive
others and general support are investigated [17].

Research suggests the impact of Enright Forgiveness Inventory
(EFI) on various issues of life. Decaporale et al. [17]
highlighted the impact of this approach on the quality of life of
middle-aged Italian women. Moreover, this approach can
effectively reduce depression, anxiety and improve the
interpersonal relationships of couples [14]. However, few
researches have been carried out on the issues of the infidelity.
Forgiveness approaches have been the focus of research in the
past. Recent studies indicate that forgiveness is a psychological
construct and a therapeutic approach to deal with
communication problems and conflicts between the married
couples. Couples who forgive each other ’ s mistakes will
experience higher satisfaction and commitment. In addition,
forgiving our own and other’s mistakes will reduce stress,
blame-casting, hostile behavior, and aggression in
interpersonal relations. Hence, people will experience more
compatibility and healthier relationships. Emphasizing it as a
trait for the believers, Islamic literature refers to forgiveness as
a therapy as well. Forgiveness therapy is one of the approaches
used in the field of controlling and treating the responses to
marital infidelity.

Methods

In this research, a single-case experimental design was used.
The population included all women affected by infidelity
referring to Ahvaz counseling centers in 2016. The participants
entered the baseline phase and then received the 8 sessions of
treatment and follow-up, which lasted two months. The study
sample which included 4 women referring to Ahvaz Avaye
Daroon Center was selected using available sampling method.
The participants responded to the Marital Quality
Questionnaire during the treatment and follow-up phases. The
inclusion criteria included elementary education, willingness to
cooperate for receiving counseling intervention, at least one
year of marriage, expressing remorse, requesting forgiveness,
and psychological health. In contrast, the exclusion criteria
included personality disorders, paranoid states, definitive
decision for divorce and infidelity. The data were analysed
using visual analysis, clinical significance (Reliable Change
Index and Normative Comparison), and the recovery
percentage formula.

The treatment protocol briefly included the following sessions:

Session 1

Familiarity with the basic principles of the group, including
constructive interaction of members; expressing feelings of
security and trust; providing feedback and creating an unbiased
atmosphere.

Objective: To facilitate the communication of the members
and to create a secure environment.

The person affected by infidelity compares himself with the
abuser of the offense, feels injustice and constantly reviews his
suffering. Therapeutic Strategies: Awareness of mental
efficacy; awareness of cognitive review of the guilt; an insight
into the comparison between the person affected by the
infidelity and the abuser.

Objective: To reveal the suffering and communicate with it.

Session 4

The person affected by infidelity compares himself with the
abuser of the offense, feels injustice and constantly reviews his
suffering. Therapeutic Strategies: Thinking about the results of
forgiveness; an insight into changing the attitude that actions
have consequences.

Objective: To reveal the suffering and communicate with it.

Session 5

Decision-making is the second phase in the treatment process.
The person affected by infidelity asks for justice and legal
persecution. She feels inequality and disappointment. This
worsens her negative emotions.

Therapeutic strategies: an insight into the fact that old
strategies do not work well; considering forgiveness as an
option; and trying to forgive the person who has committed
infidelity.

Objective: Trying to forgive the person who has committed
infidelity.

Session 6

The person affected by infidelity is saddened by the fact that
she has hostile feelings for the abuser, and she is keen to use
forgiveness as an option. But she still thinks that she could be
affected by wrong decisions.

Therapeutic strategies: empathy with an abuser.

Objective: Forgiving the abuser.

Session 7

The person affected by infidelity is saddened by the fact that
she has hostile feelings for the abuser, and she is keen to use
forgiveness as an option. But she still thinks that she could be
affected by wrong decisions.

Therapeutic strategies:

Objective:

Session 8

This the fourth phase in the treatment process. It allows the
sufferer to find a new meaning for her and others.

Therapeutic Strategies: Finding meaning for yourself and
others; knowing that you have made a mistake in the past and
needs help; learned from this mistake and setting new goals in
life.

Objective: Forgiving the abuser.

Research Tools

Marriage quality questionnaire

Developed by Enrigh, in 2012 [18], this scale consists of 14
items. It includes subscales of consensus, satisfaction, showing
the marital quality score of the individual. Fairclough in 2010
[19] reported that the reliability of the questionnaire for
consensus, satisfaction and cohesion was 0.79, 0.80, and 0.90
respectively. In Iran, this scale was examined by Nasser in
2011 [20] and the coefficients of internal consistency reliability
including Cronbach's alpha were examined. Accordingly, the
validity coefficients of marital quality and consensus were
respectively 0.39, 0.36 and 0.33 respectively. This was
significant at the P ≤ 0.0001. In this research, 50 subjects
completed the questionnaire and the Cronbach's alpha
coefficient was 0.67.

Findings

According to Table 1, the mean marital quality in the baseline
phases for the first, second, third and fourth participant was
35.5, 29.8, 38.3, 32.85 respectively. Accordingly, the mean
treatment for the first, second, third and fourth participant was
49.3, 44.67, 50.33 and 46.33 respectively. The values obtained
in the follow-up phase for the first, second, third and fourth
participant was 51, 45.5, 52.5 and 48 respectively. The marital
quality increased in the treatment phase for the first, second,
third and fourth participant up to 38.87, 43.66, 49.9 and 52.68,
respectively. Meanwhile, the marital quality increased in the
follow-up phase for the first, second, third and fourth
participant up to 31.41, 37.07, and 41.03 and 46.12
respectively. The second and the third participant had highest
and the least change, respectively. The reliable change index in
the treatment phase for the first, second, third and fourth
participant was 2.42, 2.6, 2.11 and 2.36 respectively (Z=1.96).

Meanwhile, reliable change index in the follow-up phase for
the first, second, third and fourth participant was 2.71, 2.74,
2.48 and 2.65 respectively (Z=1.96) (P <0.05). Therefore, the
findings indicated that Enright Forgiveness Inventory (EFI)
could improve the marital quality, especially in the second
participant.

According to Figure 1, the mean scores of the four participants
increased in the treatment phase compared to the baseline
phase. Given the Enright Forgiveness Therapy, it was
anticipated that changes would be positive for all participants
in terms of the marital quality.

Figure 1: The scores of the four participants in the baseline, treatment and follow-up phases.

The normative comparison formula was used to examine the
difference between the mean of the normal group and the
abused groups.

It should be noted that the mean (standard deviation) of the
normal and the abused groups was 50.64 (10.24) and 47.65
(2.61), respectively. The number of participants in the normal
and the abused groups was 30 and 4, respectively. Accordingly,
the degree of freedom was df = n1 + n2-2 = 32.

According to the results, t was bigger than the table with a
degree of freedom of 32. Therefore, it can be argued that there
was no clinical difference between the two groups in terms of
marital quality.

According to the results, there was no significant difference
between the abused and normal women in terms of marital
quality and the Enright Forgiveness Inventory (EFI)was
effective (Null hypothesis: The mean of the treated and normal
group was identical) (Table 2).

Significance test

Variables

Significant effect

Non-significant effect

Significant

1

2

Statistically different, clinically identical

Clinically identical

Not significant

3

4

Clinically different

Ambiguous findings

Table 2. The classification of the results of statistical significance tests for the marital quality variable.

According to the results, there was no significant difference
between the abused and normal participants in terms of marital
quality variable. In 2006, Harris [21] argued that row number
two (clinically identical) was better than other rows, since it
can be predicted that the group undergoing treatment returned
to the normal range (Figure 2).

As shown in the diagram above, the Enright Forgiveness
Inventory (EFI) could put people in normal range after
treatment or intervention. In other words, the abused
participants with a mean (score of 47.65) could obtain 40.4 in
the normal spectrum. Therefore, Enright Forgiveness Inventory
(EFI) could increase the marital quality of the participants.

Discussion

Good marriage is one of the important factors affecting the
mental health of the community. If marriage fails to provide a
favourable condition for fulfilling the psychological needs of
the couples, not only mental health cannot be realized, but also
can have negative and irreparable consequences for the
couples. Accordingly, neurological disorders, depression and
suicide are some of the major consequences. Infidelity can
affect many psychiatric disorders, including physical, cognitive
and behavioural disorders [22]. Infidelity increases marital
conflicts and reduces the marital quality. Therefore, it is
necessary to find a solution for infidelity. There are many
approaches to for treating the infidelity, one of which is the
Enright Forgiveness Therapy.

The present study investigated the effectiveness of Enright
Forgiveness Inventory (EFI)in improving the marital quality of
women affected by infidelity. According to the results
(Reliable Change Index and Normative Comparison), the
Enright Forgiveness Inventory (EFI) could increase the marital
quality of women participating. Haj Alizadeh et al. [23]
concluded that forgiveness plays an important role in
promoting the happiness and positive thinking of divorced
women. Azarhoosh et al. [24] argued that forgiveness therapy
can increase hope as an effective intervention. Movahedi et al.
[2] concluded that forgiveness therapy reduced marital
conflicts and increased the quality of life of women.

In 2017, Taherian and Rajaei [25] highlighted the effectiveness
of forgiveness therapy on marital satisfaction of the couples.
Hamidipour 2010, [26] found that Enright Forgiveness
Inventory (EFI) could increase the marital satisfaction of
couples. Decaporale et al. [17], highlighted the effectiveness of
Enright Forgiveness Inventory (EFI) on the quality of life of
women [14]. Khorramabadi [14] investigated the effectiveness
of Enright Forgiveness Inventory (EFI) on the satisfaction and
quality of couples. They argued that forgiveness serves as a
moderator mechanism and improves the marital quality
[27-32].

According to Decaporale et al. [17], the woman affected by
infidelity initially attempts to escape from the pain and
suffering using her own defence mechanisms and tries
reviewing that incident over and over again in her mind.
Finally, her view of global justice undergoes a significant
change. According to Mohammadi et al. [33], women find it very difficult to forgive their spouse at first since they regard
this as reconciliation. They argue that their spouse deserves
punishment and should escape it. However, forgiveness is
different from reconciliation. Forgiveness is an internal process
that helps women forgive their spouse and forget all about
punishment. Correcting this misconception can accelerate the
process of forgiveness. The individuals are helped to create
new insights into the marital conflicts, suffering and
discomfort. This change in beliefs and beliefs can change the
individuals’ behaviour. According to the cognitive behavioural,
cognitive and rational-emotional cognitive therapies, our
thoughts and insights can affect our behaviours. In other
words, in these approaches, therapists seek to substitute
rational thoughts with irrational thoughts [34,35].

According to Decaporale et al. [17], the individual seeks a
solution and attempts to deal with the pain and suffering.
According to Turkamani et al. [31], forgiveness prevents the
suppression of aggression or anger and releases the negative
emotions [31]. The person affected by infidelity decides to
forgive the spouse. By reducing negative emotions and
increasing positive emotions, forgiveness can help the women
develop a new perspective. In other words, the person affected
by infidelity gradually finds meaning for her suffering and
concludes that she is not the only one involved with this issue
[17]. At this phase, it can be argued that forgiveness
strengthens the marital relationship and commitment [36]. In
other words, a change of attitude helps the person rebuild trust
and commitment, increasing the marital quality [4]. According
to the Enright Forgiveness Therapy, the person affected by
infidelity happens to realize the strengths of the abuser. This
can result in a positive attitude, facilitating the process of
forgiveness. The acceptance helps the person better accept
those thoughts, rather than to avoid the problem and fight
negative thoughts. By accepting the issues, negative emotions
lose their power [32]. In addition to facilitating the process of
forgiveness, positive attitudes can increase the marital quality
and psychological well-being of the individual [37]. Positive
attitudes are one of the predictors of life satisfaction [38].

Movahedi A, Hosseini HM, Zargham, M. Forgiveness therapy: A tool for marital conflict and quality of life. Third international conference on psychology, education and lifestyle. Torbat Heydarieh Azad University.

Gerhini MK, Erghini ZK. the effectiveness of teaching positive thinking skills on marital satisfaction. Third scientific and research congress on the development and promotion of educational sciences and psychology, sociology and social cultural sciences of Iran, Tehran, Scientific society for the promotion and development of basic sciences and techniques.

Case B. Healing the wounds of in fidelity through the healing power of apology and forgiveness. J Cou Rel Ther 2005; 4:41-54.

Qorbani. the relationship between mental health and the quality of children. Journal of Refahe Ejtemaei 2010; 18:55-77.

Cheraghi AS. The relationship between excitement and quality of marital relationship and the marital infidelity. International Conference on New Horizons in Educational Sciences, Psychology and Social Violence. Tehran, Society of Modern Science and Technology.

Azarhoosh N, Kimayei SA, Mashhadi. An investigation into the effectiveness of Robert Enright Forgiveness Inventory (EFI) to increase the hope of divorced women. The Booklet on the 9th International Psychiatric Congress of the Asian Summit on Cultural Values. Tehran 2017.

Taherian, M, Rajaei MM. The effectiveness of forgiveness therapy on increasing marital satisfaction of women. Third national conference on strategies for the development and promotion of education sciences, psychology, consulting and education in Iran 2017.

Hamidipour. An investigation into the effect of group counselling on marital satisfaction. Journal of Psychology and Religion 2010; 3:107-123.